Diabetic nephropathy is the commonest cause of end-stage renal failure requiring renal replacement therapy in the Western world. The development of microalbuminuria in insulin dependent and non-insulin dependent diabetes mellitus is associated with a higher risk of progression to overt diabetic nephropathy and an increased risk of cardiovascular disease. Only a subset of patients with diabetes mellitus seem to be at risk of this complication but the factors underpinning the susceptibility of certain individuals remain to be elucidated. Both haemodynamic and metabolic insults have been shown to be important in the genesis of this important complication. Interactions between these deleterious derangements and individual susceptibility factors need to be further clarified
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